20210336 Ver 1_ePCN Application_20210406

I I DWR
Division of Water Resources
Pre-Construction Notification (PCN) Form
October 26,2020 Ver 3.3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
6 Yes
✓ No
Is this project a public transportation project?*
0 Yes r No
Change only if needed.
BIMS#Assigned* Version#*
20210336 1
Is a payment required for this project?*
✓ No payment required Reviewing Office*
6 Fee received Winston-Salem Regional Office-(336)776-
✓ Fee needed-send electronic notification 9800
Select Project Reviewer*
Dave Wanucha:eads\djwanucha
Information for Initial Review
1a.Name of project:
Beeson Road Bridge Replacement
1a.Who is the Primary Contact?*
Della Moore
lb.Primary Contact Email:* 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
4/6/2021
Nearest Body of Water
Reedy Fork Creek
Basin
Cape Fear
Water Classification
Roanoke
Site Coordinates
Latitude: Longitude:
36.133571 -80.014296
Pre-Filing Meeting Information
ID# Version
20210336 1
Pre-fling Meeting or Request Date*
2/16/2021
Attach documentation of Pre-Filing Meeting Request here:*
Beeson Rd Pre-filing Request.pdf 55.37KB
A. Processing Information C^U
County(or Counties)where the project is located:
Guilford

Is this a NCDMS Project
✓ Yes r No
Is this project a public transportation project?*
✓ Yes r No
Is this a NCDOT Project?*
✓ Yes r No
(NCDOT only)T.I.P.or state project number:
400085
WBS#(2)
17BP.7.R.131
1a.Type(s)of approval sought from the Corps:
(7 Section 404 Permit(wetlands,streams and waters,Clean Water Act)
r Section 10 Permit(navigable waters,tidal waters,Rivers and Harbors Act)
Has this PCN previously been submitted?*
✓ Yes
r No
lb.What type(s)of permit(s)do you wish to seek authorization?
fJ Nationwide Permit(NWP)
r Regional General Permit(RGP)
r Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
C Yes rNo
Nationwide Permit(NWP)Number: 14-Linear transportation
NWP Numbers(for multiple NWPS):
Id.Type(s)of approval sought from the DWR:
17 401 Water Quality Certification-Regular r 401 Water Quality Certification-Express
r Non-404 Jurisdictional General Permit 17 Riparian Buffer Authorization
r Individual Permit
le.Is this notification solely for the record because written approval is not required? *
For the record only for DWR 401 Certification: r Yes r No
For the record only for Corps Permit: r Yes r No
If.Is this an after-the-fact permit application?*
✓ Yes r No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
CYes rNo
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
✓ Yes rNo
Acceptance Letter Attachment
lh.Is the project located in any of NC's twenty coastal counties?
CYes rNo
1j.Is the project located in a designated trout watershed?
✓ Yes r No
B. Applicant Information
Id.Who is applying for the permit?
7 Owner r Applicant(other than owner)
le.Is there an Agent/Consultant for this project?*
✓ Yes r No
2.Owner Information
2a.Name(s)on recorded deed:
NCDOT

2b.Deed book and page no.:
2c.Responsible party:
2d.Address
Street Address
P.O.Box 14996
Address Line 2
aty State/Rovince/Region
Greensboro NC
Postal/Zip Coyle Country
27415 USA
2e.Telephone Number: 2f.Fax Number:
[phone]
2g.Email Address:*
[e-mail]
....__.........
C. Project Information and Prior Project History
1. Project Information
lb.Subdivision name:
(if appropriate)
1c.Nearest municipality/town:
Belem Creek/Oak Ridge
2. Project Identification
2a.Property Identification Number: 2b.Property size:
2c.Project Address
Street Address
Address Line 2
aly State/Rovince/Ftgion
Postal/Zip Code Country
3.Surface Waters
3a.Name of the nearest body of water to proposed project:*
Reedy Fork Creek
3b.Water Resources Classification of nearest receiving water:*
Roanoke
3c. What river basin(s)is your project located in?*
Cape Fear
3d.Please provide the 12-digit HUC in which the project is located.
030300020101
4. Project Description and History
4a.Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:*
NCDOT's Division 7 proposes to replace Bridge No.85 on Beeson Road(SR 1858)over Reedy Fork Creek in Guilford County.Bridge No.85 was built in 1985 and has been chosen to
be replaced.The existing cross-section consists of a two-lane undivided facility whereas the proposed cross section is to consist also of a two-lane undivided facility.Existing ROW
appears to measure about 65 feet whereas proposed ROW is to be 100 feet.A study area has been generated in order to facilitate environmental planning purposes at this stage.The
study area is centered on the bridge location and measures about 1,203 feet long by about 400 feet wide,encompassing roughly 11 acres,inclusive of the existing roadway and any
modern development.The assessment area observed extends 100 feet both upstream and downstream of the existing bridge over Reedy Fork Creek and extends approximately 350
feet from each side of the bridge along Beeson Road.Water resources in the study area are part of the Cape Fear River basin[U.S.Geological Survey(USGS)Hydrologic Unit
03030002]and are subject to the Jordan Lake watershed riparian buffer rules.The study area contains two perennial streams,Reedy Fork Creek and an unnamed tributary to Reedy
Fork Creek,Stream SA(T&E Survey).The vicinity is mostly forest-woodland and residential;with the nearest town being Oak Ridge.
4b.Have Corps permits or DWR certifications been obtained for this project(including all prior phases)in the past?*
C Yes G No C Unknown
4d.Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site.(for DWR)
Beeson Rd Topo Map.pdf 288.22KB
4e.Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site.(for DWR)

Beeson Rd Soil Map.pdf 379.46KB
4f.List the total estimated acreage of all existing wetlands on the property:
0.02
4g.List the total estimated linear feet of all existing streams on the property:
85
4h.Explain the purpose of the proposed project:*
Bridge No.85 has been chosen to be replaced due to the numerous repairs,poor functionality over time,aging deficiently,and skewed alignment in which the final outcome calls for
total replacement.
4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
The existing structure is a two span bridge(2@38'-2")and is a steel deck on I-Beams supported by steel caps on the piles.The proposed structure is a single span 33"prestressed box
beams with 4'deep caps,1 @85'.This structure has been designed to have as little environmental,wetland,and surface water impacts as possible.Permanent drainage easement
(PDE)will be set to have as little wetland impacts as possible.To avoid direct discharge of bridge storm water into the receiving water,deck drains are not required for the proposed
bridge.Storm water impacts to the stream have been minimized by utilizing grated inlets and pipes to collect bridge storm water and use rip rap outlet protection at station 15+17 RT to
dissipate energy to provide a non erosive flow into the stream.In the NE quadrant,there is an existing lateral V ditch that will be retained and a Class B rip rap pad outlet at station
13+12 LT will be added where the flow will diffuse into the adjacent wooded area.In the SE quadrant,there is an existing roadside ditch that will be retained and toe protection will be
added to protect the fill slope.In the SW quadrant,there is an existing lateral V ditch that will be shifted to the west and lined with PSRM.This ditch flows into an 18"drive pipe at station
16+91 RT where it discharges into a Class B rip rap pad at an embankment into an intermittent JS.In the NW quadrant,the first section of the proposed ditch will be lined with PSRM
and shifted away from the roadway.This flows into a proposed 18"drive pipe where the water continues into another ditch that is lined with Class B rip rap until the water is discharged
into Reedy Fork at station 15+92 RT.The existing ditch that runs along the roadway will be redirected and shifted to flow through the wetlands.Due to the nature of low impact bridge
replacement,the increases in storm water discharges(post v.pre condition)are negligible.Therefore additional storm water measures are not required.Equipment used to remove and
construct a new structure includes but is not limited to excavators,backhoes,cranes,dump trucks,compactors,hand tools and other heavy equipment materials.
4j.Please upload project drawings for the proposed project.
Beeson Rd Permit Plans.pdf 3.47MB
5.Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
✓ Yes r No C Unknown
Comments:
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
✓ Preliminary r Approved r Not Verified a Unknown r N/A
Corps AID Number:
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known):
Agency/Consultant Company: Axiom Environmental
Other:
5d1.Jurisdictional determination upload
Bridge 85 Guilford final summary letter 190628.pdf 1.6MB
6. Future Project Plans
6a.Is this a phased project?*
✓ Yes f No
Are any other NWP(s),regional general permit(s),or individual permits(s)used,or intended to be used,to authorize any part of the proposed project or related activity?
D. Proposed Impacts Inventory
1. Impacts Summary
1a.Where are the impacts associated with your project?(check all that apply):
fJ Wetlands 17 Streams-tributaries 17 Buffers
r Open Waters r Pond Construction
2.Wetland Impacts
2a.Site#*(?) 2a1 Reason(?) 2b.Impact type*(?) 2c.Type of W.* 2d.W.name* 2e.Forested* 2f.Type of 2g.Impact
Jurisdicition*(?) area*
L-14+49 to Box Beam P Isolated Wetlands WA Yes Both 0.010
15+85 (acres)

2g.Total Temporary Wetland Impact 2g.Total Permanent Wetland Impact
0.000 0.010
2g.Total Wetland Impact
0.010
2h.Comments:
3.Stream Impacts
3a.Reason for impact(?) 3b.lmpact type* 3c.Type of impact* 3d.S.name* 3e.Stream Type* 3f.Type of 3g.S.width* 3h.Impact
(?) Jurisdiction* length*
S1 Ebsting Bent Removal Temporary Excavation SA Perennial Both 50 31
Average(feet) (linear feet)
S2 Bank Stabilization Permanent Bank Stabilization SA Perennial Both 2 14
Average(feet) (linear feet)
S3 Bank Stabilization Permanent Bank Stabilization SA Perennial Both 2 9
Average(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
23 31
3i.Total stream and ditch impacts:
54
3j.Comments:
6. Buffer Impacts(for DWR)
6a.Project is in which protect basin(s)?
Check all that apply.
✓Neuse r Tar-Pamlico
✓Catawba r Randleman
✓Goose Creek 17 Jordan Lake
✓Other
6b.Impact Type 6c.Per or Temp 6d.Stream name 6e.Buffer mitigation required? 6f.Zone 1 impact 6g.Zone 2 impact
Bridge Placement P SA Yes 5,370 0
Road Crossing T SA Yes 561 0
Road Crossing T SA Yes 0 2,254
Bridge P SA Yes 0 199
Wetland in Buffer P SA Yes 139 79
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 561.00 2,254.00
Zone 1 Zone 2
Total Permanent impacts: 5,509.00 278.00
Zone 1 Zone 2
Total combined buffer impacts: 6,070.00 2,532.00
6i.Comments:
Supporting Documentation
Beeson Rd Stormwater Plans.pdf 64.71KB
E. Impact Justification and Mitigation

1.Avoidance and Minimization
1a.Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
This structure has been designed to have as little environmental,wetland,and surface water impacts as possible.Permanent drainage easement
(PDE)will be set to have as little wetland impacts as possible.To avoid direct discharge of bridge storm water into the receiving water,deck drains are
not required for the proposed bridge.Storm water impacts to the stream have been minimized by utilizing grated inlets and pipes to collect bridge
storm water and use rip rap outlet protection at station 15+17 RT to dissipate energy to provide a non erosive flow into the stream.In the NE quadrant,
there is an existing lateral V ditch that will be retained and a Class B rip rap pad outlet at station 13+12 LT will be added where the flow will diffuse into
the adjacent wooded area.In the SE quadrant,there is an existing roadside ditch that will be retained and toe protection will be added to protect the fill
slope.In the SW quadrant,there is an existing lateral V ditch that will be shifted to the west and lined with PSRM.This ditch flows into an 18"drive pipe
at station 16+91 RT where it discharges into a Class B rip rap pad at an embankment into an intermittent JS.In the NVV quadrant,
the first section of the proposed ditch will be lined with PSRM and shifted away from the roadway.This flows into a proposed 18"drive pipe where the
water continues into another ditch that is lined with Class B rip rap until the water is discharged into Reedy Fork at station 15+92 RT.The existing
ditch that runs along the roadway will be redirected and shifted to flow through the wetlands.Due to the nature of low impact bridge replacement,the
increases in storm water discharges(post v.pre condition)are negligible.Therefore additional storm water measures are not required.
lb.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
A work sequence has been established comprised of Best Management Practices for construction and erosion control to reduce any possible runoff
discharging into the stream.Effective erosion control and safety measure has been put in place prior to the start of construction.This project will be
monitored through inspections for compliance and will have a representative from NCDOT on-site for the duration of the project.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a.Does the project require Compensatory Mitigation for impacts to Waters of the U.S.or Waters of the State?
✓ Yes ( No
2b.If this project DOES NOT require Compensatory Mitigation,explain why:
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
1a.Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
( Yes rNo
What type of SCM are you providing?
n Level Spreader
n Vegetated Conveyance(lower SI- T)
n Wetland Swale(higher SHVVT)
I7 Other SCM that removes minimum 30%nitrogen
7 Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
Beeson Rd Stormwater Plans.pdf 64.71KB
2.Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
✓ Yes ( No
2b.Does this project meet the requirements for low density projects as defined in 15A NCAC 02H.1003(2)?
( Yes r No
Comments:
G. Supplementary Information
1. Environmental Documentation
1a.Does the project involve an expenditure of public(federal/state/local)funds or the use of public(federal/state)land?*
( Yes rNo
lb.If you answered"yes"to the above,does the project require preparation of an environmental document pursuant to the requirements of the National or State(North Carolina)
Environmental Policy Act(NEPAUSEPA)?*
✓ Yes No
Comments:*
N/A
2.Violations(DWR Requirement)

2a.Is the site in violation of DWR Water Quality Certification Rules(15A NCAC 2H.0500),Isolated Wetland Rules(15A NCAC 2H.1300),or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules(15A NCAC 2B.0200)?*
✓ Yes 6. No
3. Cumulative Impacts(DWR Requirement)
3a.Will this project result in additional development,which could impact nearby downstream water quality?*
✓ Yes f No
3b.If you answered"no,"provide a short narrative description.
4.Sewage Disposal(DWR Requirement)
4a.Is sewage disposal required by DWR for this project?*
✓ Yes ( No r N/A
5. Endangered Species and Designated Critical Habitat(Corps Requirement)
5a.Will this project occur in or near an area with federally protected species or habitat?*
( Yes r No
5b.Have you checked with the USFWS concerning Endangered Species Act impacts?*
( Yes r No
5c.If yes,indicate the USFWS Field Office you have contacted.
Raleigh
5d.Is another Federal agency involved?*
✓ Yes ( No r Unknown
5e.Is this a DOT project located within Division's 1-8?
✓ Yes r No
5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS Website,Aquatic Survey Performed
Consultation Documentation Upload
Beeson Rd T&E Survey.pdf 1.6MB
6. Essential Fish Habitat(Corps Requirement)
6a.Will this project occur in or near an area designated as an Essential Fish Habitat?*
✓ Yes ( No
6b.What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NMFS County Index
7. Historic or Prehistoric Cultural Resources(Corps Requirement)
7a.Will this project occur in or near an area that the state,federal or tribal governments have designated as having historic or cultural preservation status?*
ft, Yes r No
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
SHPO
7c.Historic or Prehistoric Information Upload
Beeson Rd No Archaeological Survey.pdf 1.23MB
Beeson Rd No Architecture Survey.pdf 3.29MB
8. Flood Zone Designation(Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain?*
(c Yes r No
8b.If yes,explain how project meets FEMA requirements:
NCDOT Hydraulic coordination with FEMA:The location fall under minimal flooding hazard.
8c.What source(s)did you use to make the floodplain determination?*
FEMA maps
Miscellaneous L)
Comments

Miscellaneous attachments not previously requested.
Signature
R By checking the box and signing below,I certify that:
• The project proponent hereby certifies that all information contained herein is true,accurate,and complete to the best of my knowledge and belief;and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• I have given true,accurate,and complete information on this form;
• I agree that submission of this PCN form is a"transaction"subject to Chapter 66,Article 40 of the NC General Statutes(the"Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66,Article 40 of the NC General Statutes(the"Uniform Electronic Transactions Act");
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature;AND
• I intend to electronically sign and submit the PCN form.
Full Name:
W.R.Archer Ill,PE
Signature
W.G(rotne '
Date
4/6/2021